Monday, September 6, 2010

Baby Stephen~

This morning I was called to a birth. The mom was one of my prenatal patients and had learned in my classes that pushing too long will cause problems. I tell the women, don’t push for longer than 4 hrs at home. If your baby isn’t coming, come get help at the clinic.

I know some of you midwives (and OBs) out there will argue that pushing longer than two hours is abnormal. But these women won’t come after just two hours. So we agreed that 4 hours is WAY too long. They have started to listen.

Well, this sweet mom pushed so long at home (at her traditional midwife’s prodding) that her labia became painfully swollen. (Not having a clock, she couldn’t tell me how long it was exactly.) So, she insisted that the midwife bring her to the clinic. I’m so glad she did!

When I check her in, the fetal heart tones were normal and everything seemed in order -- except the ridiculous swelling. She was 9 + dilated with a swollen anterior lip, so I encouraged her NOT to push while I massaged it slowly away.

But the minute she had a contraction, she pushed like crazy. He was born within minutes of arriving at the clinic. Wonderful, right?       Wrong.

He was severely compromised. I don’t know what happened in the 10 minutes from normal FHTs and “the push”. But he was not well. Covered in dark chocolate brown meconium he looked even darker than normal.

Breathing in little irregular gasps, he couldn’t even be bothered to open his eyes. He was completely limp and didn’t respond for ages to all forms of stimuli. I started resuscitation efforts almost immediately but even that wasn’t helping much.

So I prayed .... and called for back-up.

Yar (my patient) watched, quiet and wide-eyed, asking for the reassurance I couldn’t give her. Is he okay? Why isn’t he moving? Won’t he cry? I didn’t know if he’d live. So I kept silent, prayed harder and worked like mad.

At his first hint of a cry... we rejoiced like little girls. Yar was all smiles. Her confidence in me was remarkable. She trusted me and was totally calm. It was so reassuring... and I must confess, not totally deserved. But by the time back-up arrived, this precious boy was doing fine with an apgar of 8. God did such a miracle!

I handed him over for monitoring and turned my focus back on Yar. She was bleeding considerably and was still oozing chocolate brown meconium. I can only assume that the long pushing at home caused fetal distress and compromise -- thus the thick meconium and hypoxia at birth.

The placenta was born without ceremony but it was unhealthy, mec stained and calcified in several parts.

I told her how glad I was she came to the clinic. She just smiled a white contagious smile and hugged him close to her chest. She understood he shouldn’t have lived but did.

Later, through my translator she told me that since I helped him live, he was my baby too. She asked to name him after me and told me that she’d be bringing him regularly to visit.

So rejoice with me as I have another name sake -- baby Stephen. Praise God for this sweet answer to prayer. He stirred in him life. For He is the life giver! May this little boy praise Him with his every breath!

Post notes: He is the biggest-bounciest-beautifulest baby I’ve delivered yet in Sudan! He weighs in at 4 kgs and is long enough to be 4 month old! He was so big in fact that Dennis wanted to rule out maternal diabetes. He was convinced he was macrosomic. But he wasn’t... just big and beautiful and breathing!

Thank you Jesus!